Why Indians are Stressed and Unhealthy

By Aakar Patel

Manmohan Singh had his arteries bypassed on Saturday, a procedure that increasing numbers of Indians are having. Last year, medical journal Lancet reported a study of 20,000 Indian patients and found that 60 per cent of the world’s heart disease patients are in India, which has 15 per cent of the world’s population.

This number is surprising because reports of obesity and heart disease focus on fat Americans and their food. What could account for Indians being so susceptible — more even than burger-and-fries-eating Americans?

Four things: diet, culture, stress and lack of fitness.

There is no doctrinal prescription for vegetarianism in Hindu diet, and some texts explicitly sanction the eating of meat. But vegetarianism has become dogma.

Indian food is assumed to be strongly vegetarian, but it is actually lacking in vegetables. Our diet is centered round wheat, in the north, and rice, in the south. The second most important element is daal in its various forms. By weight, vegetables are not consumed much. You could have an entire South Indian vegetarian meal without encountering a vegetable. The most important vegetable is the starchy aloo. Greens are not cooked flash-fried in the healthy manner of the Chinese, but boiled or fried till much of the nutrient value is killed.

Gujaratis and Punjabis are the two Indian communities most susceptible to heart disease. Their vulnerability is recent. Both have a large peasant population — Patels and Jats — who in the last few decades have moved from an agrarian life to an urban one. They have retained their diet and if anything made it richer, but their bodies do not work as much. This transition from a physical life to a sedentary one has made them vulnerable.

Gujaratis lead the toll for diabetes as well, and the dietary aspect of this is really the fallout of the state’s economic success. Unlike most Indian states, Gujarat has a rich and developed urban culture because of the mercantile nature of its society. Gujaratis have been living in cities for centuries.

His prosperity has given the Gujarati surplus money and, importantly, surplus time. These in turn have led to snacky foods, some deep-fried, some steamed and some, uniquely in India, baked with yeast. Most Indians are familiar with the Gujarati family on holiday, pulling out vast quantities of snacks the moment the train pushes off.

Gujarati peasant food — bajra (millet) roti, a lightly cooked green, garlic and red chilli chutney, and buttermilk — is actually supremely healthy. But the peasant Patel has succumbed to the food of the ‘higher’ trader and now prefers the oily and the sweet.

Marathi peasant food is similar, but not as wholesome with a thick and pasty porridge called zunka replacing the green.

Bombay’s junk food was invented in the 19th century to service Gujarati traders leaving Fort’s business district late in the evening after a long day. Pao bhaji, mashed leftover vegetables in a tomato gravy, served with shallow-fried buns of bread, was one such invention.

The most popular snack in Bombay is vada pao, which has a batter-fried potato ball stuck in a bun. The bun — yeast bread — is not native to India and gets its name pao from the Portuguese who brought it in the 16th century. Bal Thackeray encouraged Bombay’s unemployed Marathi boys to set up vada pao stalls in the 60s, which they did and still do.

The traveling chef and TV star Anthony Bourdain called vada pao the best Indian thing he had ever eaten, but it is heart attack food.

Though Jains are a very small part (one per cent or thereabouts) of the Gujarati population, such is their cultural dominance through trade that many South Bombay restaurants have a ‘Jain’ option on the menu. This is food without garlic and ginger. Since they are both tubers (as also are potatoes), Jains do not eat them, because in uprooting them from the soil, living organisms may be killed (no religious restriction on butter and cheese, however!). The vast majority of Ahmedabad’s restaurants are vegetarian. Gujaratis have no tolerance for meat-eaters and one way of keeping Muslims out of their neighborhoods is to do it through banning ‘non-vegetarians’ from purchasing property in apartment buildings.

Even in Bombay, this intolerance prevails. Domino’s, the famous pizza chain, has a vegetarian-only pizza outlet on Malabar Hill (Jinnah’s neighborhood). Foreigners like Indian food, and it is very popular in England, but they find our sweets too sweet. This taste for excess sugar extends also to beverage: Maulana Azad called Indian tea ‘liquid halwa’. Only in the last decade have cafes begun offering sugar on the side, as diabetes has spread.

India’s culture encourages swift consumption. There is no conversation at mealtime, as there is in Europe. Because there are no courses, the eating is relentless. You can be seated, served and be finished eating at a Gujarati or Marathi or South Indian thali restaurant in 15 minutes. It is eating in the manner of animals: for pure nourishment.

We eat with fingers, as opposed to knives and forks, or chopsticks, resulting in the scooping up of bigger mouthfuls. Because the nature of the food does not allow for leisurely eating, Indians do not have a drink with their meals. We drink before and then stagger to the table.

As is the case in societies of scarcity, rich food is considered good — and ghee is a sacred word in all Indian languages. There is no escape from fat. In India, advertising for healthy eating also shows food deep-fried, but in lower-cholesterol oil.

The insistence by family – ‘thoda aur le lo’ — at the table is part of our culture of hospitality, as is the offering of tea and perhaps also a snack to visiting guests and strangers. Middle class Indians, even families that earn Rs10,000 a month, will have servants. Work that the European and American does, the Indian does not want to do: cooking, cleaning, washing up.

Painting the house, changing tyres, tinkering in the garage, moving things around, getting a cup of tea at the office, these are things the Indian gets someone else to do for him. There is no sense of private space and the constant presence of the servant is accepted.

Gandhi’s value to India was not on his political side, but through his religious and cultural reforms. What Gandhi attempted to drill into Indians through living a life of action was a change in our culture of lethargy and dependence. Gandhi stressed physical self-sufficiency, and even cleaned his toilet out himself.

But he wasn’t successful in making us change, and most Indians will not associate Gandhi with physical self-sufficiency though that was his principal message. Indian men do no work around the house. Middle class women do little, especially after childbirth. Many cook, but the cutting and cleaning is done by the servant. Slim in their teens, they turn thick-waisted in their 20s, within a few years of marriage.

Since we are dependent on other people, we have less control over events. The Indian is under stress and is anxious. This is bad for his health. He must be on constant guard against the world, which takes advantage of him: the servant’s perfidy, encroachment by his neighbors, cars cutting in front of him in traffic, the vendor’s rate that must be haggled down. Almost nothing is orderly and everything must be worried about.

In the Indian office, the payroll is a secret, and nobody is told what the other makes. Knowledge causes great stress, though the lack of information is also stressful, leading to spy games and office gossip.

Because there is no individualism in India, merit comes from seniority and the talented but young executive is stressed by the knowledge that he’s not holding the position he deserves. Indians are peerless detectors of social standing and the vertical hierarchy of the Indian office is sacrosanct.

Dennis Kux pointed out that Indian diplomats do not engage officially with an American of lower rank, even if the American was authorized to decide the matter. In the last decade, when Indians began owning companies abroad, the Wall Street Journal reported on cultural problems that arose. Their foreign employees learnt quickly that saying ‘no’ would cause their Indian bosses great offence, so they learnt to communicate with them as with children.

Indians shine in the west where their culture doesn’t hold them back. In India honor is high and the individual is alert to slights from those below him, which discomfort him greatly.

There is no culture of physical fitness, and because of this Indians don’t have an active old age. Past 60, they crumble. Within society they must step back and play their scripted role. Widows at that age, even younger, have no hope of remarriage because sacrifice is expected of them. Widowers at 60 must also reconcile to singlehood, and the family would be aghast if they showed interest in the opposite sex at that age, even though this would be normal in another culture.

Elders are cared for within the family, but are defanged when they pass on their wealth to their son in the joint family. They lose their self-esteem as they understand their irrelevance, and wither.

This article is reproduced from The News (January 25, 2009) with permission of the author. Read the article in French here.

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Tags: Culture, Diet, Health, Indians, Stress